Download Confidental NUR 600 Module 5 Exam (2026) | 100% Correct Questions & Answers – St. Thomas and more Exams Nursing in PDF only on Docsity!
Confidental NUR 600 Module 5 Exam (2026) |
100% Correct Questions & Answers – St.
Thomas, Exams of Nursing Graded A+|
Validate Pass
the lower esophageal sphincter is incompetent causing gastric acid to g up into the esophagus. - ANSWER -Gastroesophageal Reflux (GERD) GERD Diagnosis - ANSWER -Endoscopy biopsy and pH of esophageal contents (normal pH is close to 7.0) GERD Prevention - ANSWER -AVOID full stomach, eat small portions every 3hrs, HOB elevated, AVOID coffee, alcohol, fats, smoking! GERD Medications - ANSWER -(-ZOLE), Proton pump inhibitors: Omeprazole, Lansoprazole, Pantoprazole, metoclopramide (Reglan). (Produces anticholinergic effects, Peripheral nervous system is stimulated -FAST, DRY, DILATED) .First-Line treatment for Type 2 Diabetes Mellitus - ANSWER - Metformin Metformin is recommended as initial pharmacologic treatment for - ANSWER -type 2 diabetes. It has been shown to decrease triglycerides and LDLs. - ANSWER - Metformin
Metformin Most common side effects is - ANSWER -LACTIC ACIDOSIS Symptoms of lactic acidosis include - ANSWER -nausea abdominal pain, and tachycardia. lACTIC ACIDOSIS Test should include - ANSWER -electrolytes, ketones, and serum glucose. Obese Patients with normal renal function and elevated fasting plasma glucose may be started on - ANSWER -combination of Metformin & a second-generation sulfonylurea. should be considered for patients with diabetes during times of physical stress, such as illness or surgery. - ANSWER -Insulin Do NOT Use oral hypoglycemic meds in the - ANSWER - perioperative period. to Prevent onset or delay onset of diabetes: Patients with impaired glucose should be advised to lose - ANSWER -5% to 10% (10-15 lbs) of body weight. Testing for type 2 diabetes should be considered in all adults with BMI GREATER then - ANSWER -
Primary treatment for hypothyroidism - ANSWER - LEVOTHYROXINE (Synthroid)
- Inflammatory bowel disease (Chron's disease and Ulcerative Colitis) treatment for diarrhea - ANSWER -ANTICHOLINERGICS, SELECTIVE SEROTONIN RECEPTOR ANTAGONISTS -Clidinium/chlordiazepoxide (Librax), dicyclomine (Bentyl), Glycopyrrolate (Robinul), hyoscyamine (Levsin, Anapaz) Lotrenex( alosteron, SSRA) dispensed on - ANSWER -restricted program. Constipation predominate tx: - ANSWER -Chloride Channel Activator(CCA) or Guanylate cyclase-C Agonist(GCA): Amitiza (lubiprostone: chloride channel activator)take with - ANSWER -food Linzess (GCA) take on - ANSWER -empty stomach. Inflammatory bowel disease (Chron's disease and Ulcerative Colitis) self manage treatment - ANSWER -high fiber diet, dietary fiber, physical exercise, stress management. Inflammatory bowel disease (Chron's disease and Ulcerative Colitis) medications - ANSWER -antidiarrheal, gut antispasmodic, laxative, nerve pain medication, antibiotics and dietary supplement.
First- Line tx for type 1 diabetes mellitus: - ANSWER -Insulin gargline is indicated in patients with type 1 diabetes and insulin- dependent type 2 diabetes and is helpful for pt with wide glycemic swings. - ANSWER -Pramlintide First-line tx for HYPERTHYRODISM (GRAVES DISEASE) - ANSWER - PTU (propylthiouracil), IODINE 131, METHIMAZOLE, PROPRANOLOL
- pt with elevated T3, T4 and decreased TSH- GIVE - ANSWER - RADIOACTIVE IODINE. T3 lab - ANSWER -80- T4: lab - ANSWER -5.0 to 12. TSH: labs men - ANSWER -0.4 to 4. TSH women - ANSWER -( 0.5-5.0)
- Normal TSH + normal T4 = normal thyroid function. - ANSWER -normal thyroid function. High TSH + normal T4 = - ANSWER -you may have a higher risk of developing an underactive thyroid.
Management of Polycystic ovary syndrome (PCOS): First-line: - ANSWER -diet and exercise. Pharmacologic MANAGEMENT FOR Polycystic ovary syndrome (PCOS) is - ANSWER -reserved for metabolic derangements, such as anovulation, hirsutism, menstrual irregularities. -CHC(Combined hormonal contraceptive)s: CHC(Combined hormonal contraceptive)s: increase SHBG (sex hormone-binding globulin) (and therefore - ANSWER -decrease free testosterone -CHC(Combined hormonal contraceptive)s FOR - ANSWER -PCOS -CHC(Combined hormonal contraceptive)s helps in PCOS by - ANSWER -Regularing menstrual cycles increase SHBG (sex hormone-binding globulin) and decrease free testosterone Prevents endometrial hyperplasia Another tx for PCOS that could also be considered - ANSWER - Progestin-only contraceptive Medication to Avoid in PCOS - ANSWER -androgenic progestins paraesophageal protrusion of stomach into diaphragm SLIDING STOMACH ITNO ESOPHAGUS - ANSWER -Hiatal hernia
Hiatal hernia treatment options: When surgical repair necessary - ANSWER -only if it is large Hiatal hernia Treat with - ANSWER -PPI Managing small hiatal hernia with - ANSWER -lifestyle modifications and PPI hiatal hernia Diagnosis - ANSWER -Endoscopy or XRAY PUD: Duodenal Ulcer what alleviates the pain - ANSWER -eating what happened in PUD: Duodenal Ulcer after eating - ANSWER - Stomach empties un 30 min and burning pains return. distension of gastric wall produces pain with eathing, NOT ALLEVIATED with antacids. - ANSWER -Gastritis Gastritis DX - ANSWER -Endoscopy (both) H.pylori bacteria from both Gastritis most common in - ANSWER -hispanics What test detect H. pylori - ANSWER -Urea breath test & stool antigen test
Causes that contribute to constipation. - ANSWER -Calcium Channel Blocker, IRON, antihistamines, antipsychotics *If constipation associated with GI bleed - ANSWER -look for colon cancer what laxative to recommend - ANSWER -saline laxatives Never use laxative - ANSWER -long term what happened if the Pt will get used to laxative - ANSWER -need bowel training. *ENEMA is like - ANSWER -osmotic agent Stimulant are not laxative; it is for constipation prevention. - ANSWER -: bisacodyl, senna, castor oil. Emollient/ stool softeners: Docusate- Mineral oil. Patient comes in with C/O severe abd cramping and XR shows lot of Fecal matter - ANSWER -TREAT WITH ENEMA Pt on stimulant (Bisocodyl, Dulcolax) c/o pain, using daily for several years, underweight what to do - ANSWER -Taper down on stimulant lax and start on stool softener. Pt on bulk lax to prevent constipation reports it is not working anymore. - ANSWER -ADD STOOL SOFTENER DOCUSATE TO
Pt on bulk lax to prevent constipation reports it is not working anymore why not adding lactulose or bisacodyl - ANSWER -THEY WILL PRODUCE ABD PAIN AND CRAMPING. Metamucil/fiber interferes with absorption of many medications always take - ANSWER -2 hours before and then take laxitive
. the American Dietetic Association fiber recommendation - ANSWER -20 to 35g *the American Dietetic Association fiber recommendation For wheelchair bound or bedbound patients use - ANSWER - MIRALAX Encourage fluid intake Patient who abuse laxatives are at risk for - ANSWER -cathartic colon and for electrolyte imbalance Patient who abuse laxatives should be weaned off stimulant lax and placed on safer long-term lax such as - ANSWER -BULK Lax (methylcellulose, psyllium) or Stool softener (docusate) Patients treated for long-term constipation should begin with - ANSWER -bulk lax (Methylcellulose, Psyllium). Patients treated for long-term constipation should begin with bulk lax (Methylcellulose, Psyllium). If that is not effective, then add a - ANSWER -second laxative
Avoid antiemetics during pregnancy Try: - ANSWER -Dextrose, Thyamine, Multivitamin. has been shown to be safe and effective (off label) for hyperemesis gravidum during pregnancy - ANSWER -Odanestron Toxicity = - ANSWER -Cardiac Arrythmias IF Vomiting is not controlled what can happen - ANSWER - dehydration may occur How do you treat dehydration - ANSWER -ER with IV fluids Most common class of antiseptics for N/V - ANSWER - ONDANSETRON Vertigo (Motion sickness) - ANSWER -* Excessive stimulation of vestibular of ear. The transdermal system allows steady- state plasma level of scopolamine to be reached rapidly & maintained for 3 days. - ANSWER -Vertigo (Motion sickness) vertigo Goal is to target - ANSWER -Histamine receptors (scopolamine patch, antihistamines: meclizine/antivert, promethazine, Benadryl, Serotonin antagonist: Ondansetron/Zofran) Motion Sickness Prophylaxis.
Scopolamine patch how often? - ANSWER -EVERY 3 days 2 days post-op, patient using ondansetron for nausea, now hypotensive & feeling faint = - ANSWER -symptoms of toxicity. Room is spinning - ANSWER -vertigo *Otolith in the ear need to be aligned to maintain equilibrium When lose equilibrium this stimulates - ANSWER -VERTIGO more advanced inner ear disorder that causes sensory neuro loss & tinnitus & vertigo. - ANSWER -Meniere's disease Pt spinning in room, feeling vertigo. Primary Care MD: GIVE - ANSWER -MECLIZINE (ANTIHISTAMINE) Pt having vertigo, fever, borderline BP what to do - ANSWER - hospital for IV hydration chemo pt with N&V: Treatment: - ANSWER -Ondansetron Child with vomiting for several days, dry, hypotensive - ANSWER - IV HYDRATION Patient with vertigo May experience whirling or a feeling of the room spinning around. In true Vertigo, the patient can - ANSWER - identify the direction in which the room is spinning.
bloating abdominal pain diarrhea: Ask patient if the symptoms are in relation with the pain and stool? Treat with - ANSWER - dicyclomide/bentyl IBS diarrhea bloating and abd pain but does not want meds. Treat with - ANSWER -increase fiber 20-30g per day. Antispasmodic medication and antidiarrheal being taken by patient. Having Difficulty urinating, dry mouth, constipation. Tx: - ANSWER -Lower use of Antispasmodic Patient with IBS taking hyosoyamine and simethicone and tricyclic acid for depression. Reporting continuous diarrhea. ANSWER : - ANSWER -Send patient to gastroenterologist, prob needs endoscopy and DISCONTINUE Meds. Pt on Reglan (metoclopramide) and developing extrapyramidal symptoms (EPS). Treat with - ANSWER -COGENTIN or BENADRYL recurrent abd pain in relation to defecation, changes in frequency of stool. Constipation or diarrhea alleviates pain. - ANSWER -IBS IBS NEURO relationship DX: - ANSWER -Rome criteria IBS Treatment: - ANSWER -Support, Antianxiety, antidepressant, increase fiber and hydration.
IBS CONSTIPATED: - ANSWER -Lubiprostone (Amitiza) IBS DIARRHEA: - ANSWER -Antidiarrhea such as Loperamide, Alosetron (if associated with ischemic colitis, DO NOT give, its restricted) IBS patient with diarrheaa associated with ischemic colitis do not give ____ - ANSWER -antidiarrheal Elderly individuals with hypothyroidism may experience exacerbation of - ANSWER -cardiovascular disease and angina with thyroid hormone replacement. Elderly individuals with hypothyroidism recommendation - ANSWER -It is advisable to start LOW at 25mcg and work up as tolerated. Pt should be told not to change brands of ___________ there is potential variability in bioequivalence between manufacturers. - ANSWER -levothyroxine levothyroxine Medication should be taken - ANSWER -same time each day before breakfast. Or on an empty stomach. Complications of Hypothyroid treatment is to administer larger doses and develop - ANSWER -Hyperthyroidism
HYPERTHYROIDISM treat with - ANSWER -Radioactive Iodine Elderly patient with increased TSH and decreased T4- Give - ANSWER -Levothyroxine 23 mcg Child with congenital hypothyroidism talking levothyroxine. Now 3 y/o will on levothyroxine MANAGEMENT: - ANSWER -Treatment can be stopped and measure T4 and TSH levels Teaching for levothyroxine? - ANSWER -Never Change Brands. Taking Synthroid and now showing symptoms of HYPERthyroidism Measure - ANSWER -TSH and T4 levels. May have to decrease Synthroid. TSH Low and T4 increasing what does It mean? - ANSWER - HyPerthroidism HyPerthroidism and how to treat - ANSWER -Give PTU (propylthiouracil), Iodine 131, methimazole, propranolol Pt with Graves' disease/hyperthyroidism and taking methimazole, after 6mths NP notes that T3 and T4 are normal and TSH is elevated. - ANSWER -Decrease Dose Hydrochloric acid (HCL)and Pepsin are responsible for gastric mucosal damage found in - ANSWER -Peptic Ulcer Disease (PUD).
Pt with Metabolic Syndrome (high bp & bs, fat around the waist, abnormal cholesterol) tx: - ANSWER -metformin, Ozempic Pt BMI 26 HDL 30 TRI 350: TREATMENT: ORDER fasting glucose levels for diagnosis of Metabolic syndrome - ANSWER -ORDER fasting glucose levels for diagnosis of Metabolic syndrome Pt BMI 26 HDL 30 TRI 350: TREATMENT could indicate - ANSWER - metabolic syndrome interferes with absorption of many medications always take 2 hours before and then take laxitive - ANSWER -Metamucil/fiber BULK Lax - ANSWER -(methylcellulose, psyllium) Patients treated for long-term constipation should begin with bulk lax - ANSWER -Methylcellulose, Psyllium To Infectious Diarrhea give - ANSWER -Bismuth
